The American Medical Group Association is urging federal policymakers not to "rush to judgment" after reading the findings of a Government Accountability Office report
that suggested physicians who own expensive diagnostic imaging equipment are more likely to order expensive imaging tests for their patients.
The report included an estimate that providers who self-referred patients for advanced imaging made 400,000 more referrals in 2010 than they would have if they didn't have a financial stake in the equipment. The GAO calculated that this cost the Medicare system an additional $109 million in 2010.
The report's release was followed by calls to action from some prominent lawmakers, who issued a news release commenting on the GAO findings
"It should serve as a wakeup call to Congress that this is an arena where we can't afford to sit idly by and allow providers to continue these practices," Rep. Pete Stark (D-Calif.) said in the release. "It's costing taxpayers millions of dollars, increasing costs on beneficiaries and exposing patients to radiation that has real health consequences."
But the AMGA, whose membership includes approximately 400 medical groups in which some 125,000 physicians practice, said the report failed to recognize how integrated multispecialty groups use diagnostic imaging to deliver the right care at the right time.
"Industry leaders like the Everett Clinic, Geisinger Health System, Park Nicollet, the Iowa Clinic, Austin Diagnostic Clinic and Quincy Medical Group are all dependent on the buttressing support of imaging and other ancillary services in their practices, and these institutions are considered by most objective observers to be the exemplars of healthcare quality and innovation," AMGA President and CEO Donald Fisher said in a news release
"Many member groups utilize decision-support tools to ensure that clinical decision-making is supported by evidence before ordering advanced diagnostic imaging for their patients," Fisher added. "Patients deserve to have access to coordinated care, which is most effectively delivered by multispecialty medical groups and other organized systems of care."
The American Association of Orthopaedic Surgeons
, in a news release, stated that in-office imaging services help ensure greater patient adherence to treatment plans and lead to improved outcomes.
"Significant technological advances have been made in our field so that patients can receive timely and accessible screenings from the comfort of their doctor's office," AAOS President Dr. John Tongue said in the release. "We believe that any restriction on this convenience would threaten the quality of care being delivered to our patients."
The GAO, in its report, recommended requiring providers to indicate on their claims form when they self-refer. It also recommended that the CMS determine and implement a payment reduction for self-referred services in order to "recognize efficiencies when the same provider refers and performs a service" and that the CMS implement an approach that determines the appropriateness of self-referred imaging services.